VEHICLE REGISTRATION & DMV PROXY
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Effective Date: ________________________________________________________
Place: _________________________________________________________________

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1. Parties
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This document is made on ____________________ (____________________) by:

Vehicle Owner
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

In favor of:

Authorized Representative
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

2. SUBJECT-MATTER SCHEDULE & SPECIFICATIONS
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Vehicle Make & Model: __________________________________________________
VIN / Chassis Number: __________________________________________________
Registration Plate: ____________________________________________________
Tasks Authorized (Registration, Title Transfer, Plates):
    ____________________________________________________________________
Authorization Valid Until: _____________________________________________

3. EXECUTION & SIGNATURES
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Vehicle Owner

Signature: _____________________________________________________________

Full Legal Name: _______________________________________________________
Date: __________________________________________________________________